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Florida Whistleblower Lawyers > Blog > Healthcare Billing Fraud > Long-Term Care Company Pays More Than $5.5 Million In Whistleblower-Initiated False Claims Act Case

Long-Term Care Company Pays More Than $5.5 Million In Whistleblower-Initiated False Claims Act Case


On August 10th, 2022, the United States Attorneys’ Office for the Southern District of Indiana announced that American Senior Communities, L.L.C (ASC)—a long-term care company with a main headquarters in Indianapolis, IN—will pay more than $5.5 million to resolve a False Claims Act lawsuit. The case involves allegations of Medicare billing fraud. Here, our healthcare billing fraud whistleblower lawyers provide a more detailed overview of the False Claims Act enforcement action.

False Claims Act Settlement Reached in Medicare Billing Fraud Case

 ASC provides assisting living care, independent living care, nursing care, and other services to elderly and disabled individuals. As with many other private companies operating in this sector, ASC bills Medicare for a significant portion of the services that it offers. There are strict rules and regulations regarding the billing of Medicare and other federal health programs.

In 2017, a former employee (whistleblower) of a third party hospice company that did business with ASC filed a False Claims Act lawsuit in a federal court in Indiana. In the lawsuit, the whistleblower alleged that ASC was fraudulently billing Medicare. Specifically, the whistleblower alleged that ASC was billing Medicare for services already covered by the hospice providers.

The long-term care company has now agreed to resolve the False Claims Act lawsuit for approximately $5.59 million. Notably, the total loss to Medicare due to the fraudulent billing was estimated at $2.7 million. Federal law allows Medicare to recoup up to a maximum of three times the amount of each false claim submitted plus an additional fine.

Whistleblower Will Receive 15 to 25 Percent of Recovery 

As with many other Medicare billing fraud cases, the enforcement action in this case was initiated by a whistleblower. The False Claims Act is a federal law that allows private individuals to step into the role of the government and file a lawsuit called a qui tam claim. Any whistleblower can file a qui tam claim.

In many cases, a whistleblower is an employee of the company that committed the alleged violation. However, that is not required under the False Claims Act. In this case, an employee of a third party company that contracted with ACS filed the claim.

The False Claims Act both empowers individual whistleblowers to file a claim and incentives them to take action. Under the law, a whistleblower who initiates a qui tam lawsuit that is then taken over by the government is entitled to an award with between 15 percent and 25 percent of the ultimate recovery.

Set Up a Free, Confidential Consultation With a Whistleblower Attorney

At Guttman, Freidin & Celler, we are dedicated to protecting the rights of whistleblowers. If you have any questions about federal health billing fraud and False Claims Act claims, we can help. Contact us today for a no cost, fully confidential consultation. With a main law office in Miami, we provide nationwide representation in federal False Claims Act whistleblower lawsuits.



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